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Biomedical subjects

S Platt

Publications and source records attributed to S Platt.

At least 55 records · Page 3Linked to original sources
PubMed1990

Long term trends in parasuicide and unemployment in Edinburgh, 1968-87.

Aggregate- and individual-level trends in parasuicide and unemployment among men and women resident in Edinburgh during the years 1968-87 are reported. During the first half of the period unemployment and parasuicide rates increased in parallel (r = 0.91, P less than 0.001 among men; r = 0.82, P less than 0.01 among women). However, while unemployment continued to rise after 1977, parasuicide rates tended to fall (r = -0.83, P less than 0.001 among men; r = -0.38, NS among women). It could be shown that the reversed relationship between parasuicide and unemployment after 1976 was not due to changes over time in the validity of the local unemployment rate as a marker of economic conditions. Suggested explanations for the falling parasuicide rate in Edinburgh include the possibility of a "threshold" effect and the influence of other (non-economic) factors. The rate of parasuicide among the unemployed fell, especially after 1973, while the rate among the employed rose until 1976-7, thereafter tending to fall. The relative risk (rate among the unemployed/rate among the employed) declined until 1979, since when it has fluctuated at about 10. The highest rate of parasuicide was consistently found among the long-term unemployed.

Adolescent↗
PubMed1990

Suicidal intent, hopelessness and depression in a parasuicide population: the influence of social desirability and elapsed time.

This paper reports the first British study to assess the construct validity of Beck's Hopelessness Scale (HS) and the Beck Depression Inventory (BDI). On the basis of interviews with 50 economically active parasuicide patients, it was confirmed that hopelessness accounts for the relationship between depression and suicidal intent. Moreover, it was shown that social desirability neither confounds the relationship between hopelessness and suicidal intent, nor has any predictive power in explaining variation in suicidal intent. On the other hand, the interval ('elapsed time') between the commencement of the parasuicidal act and of the research interview was significantly and positively correlated with suicidal intent, and elapsed time was a significant predictor of the total score on Beck's Suicidal Intent Scale. Two explanations for this finding are proposed: the first is based on the possibility that elapsed time is an indirect or proxy measure of medical seriousness; the second derives from the likely impact of prolonged hospital stay on the patient's interpretation or understanding of his/her behaviour. Researchers are advised to take into account the moderating effect of elapsed time when designing studies which examine psychological processes in parasuicide.

Adolescent↗
PubMed1990

General hospital admission in the management of parasuicide. A randomised controlled trial.

Suitably trained junior doctors selected parasuicides with no immediate medical or psychiatric treatment needs on initial assessment in a casualty department. This group was then randomly allocated to hospital admission (38 cases) or discharge home (39 cases). One week later there were no significant differences between groups on diverse outcome measures, including repetition rate, psychological symptoms, and social functioning. A second follow-up using the same measures at 16 weeks also failed to demonstrate any differences between groups, both of which showed considerable overall improvement. A parasuicide management policy consisting of assessment in a casualty department and selective discharge was appropriate for 15% of a hospital-referred population. This lends support to recent government recommendations, but caution should be exercised before such a result is generalised.

Adult↗
PubMed1988

Recent clinical and epidemiological trends in parasuicide in Edinburgh and Oxford: a tale of two cities.

This is a report of clinical and epidemiological trends in parasuicide in Edinburgh and Oxford over the period of 1976 to 1984. Rates of parasuicide declined in both cities, but more markedly among women than men. Male rates tended to be higher in Edinburgh and female rates higher in Oxford. Age-specific rates were similar for the two cities in 1983-84, with peak rates for females among 15-19 year olds and those for males among 20-24 year olds in Edinburgh and 25-34 year olds in Oxford. Parasuicide incidence was higher in lower social class groups and among the unemployed in both cities. During the study period there was a massive decline in barbiturate overdoses, a more modest decline in minor tranquillizer overdoses but, in Oxford, a marked increase in self-poisoning with paracetamol. By the end of the study period the proportion of patients receiving a diagnosis of drug addiction had doubled in Edinburgh, although it had remained fairly constant in Oxford. There were differences in patterns of aftercare offered to patients in the two cities; these almost certainly reflect differing clinical policies.

Adolescent↗
PubMed1987

The aftermath of Angie's overdose: is soap (opera) damaging to your health?

In a study designed to evaluate the behavioural impact of a fictional parasuicide--namely, Angie's overdose on the popular television soap opera EastEnders--information about cases of deliberate overdose treated in accident and emergency departments in 63 hospitals throughout Britain was obtained for the week after the televised overdose (experimental period) and the week before the overdose (control period). After adjusting for trends in the equivalent weeks in a control year (1985) the increase in the cases of parasuicide treated by hospitals during the experimental week was not found to be significant. A significant increase (31%) was found among people aged greater than or less than 45, but this is not thought to be reliable. The increase among women alone (21%) was significant with a one tailed test. Contrary to expectations there was a positive association between trends in overdose and distance from London--that is, the further the distance of the region from London the greater the increase in cases of overdose during the experimental period--and a negative association between trends in overdose and viewing figures--that is, the higher the viewing figure the less the impact on the incidence of overdoses. These findings do not lend support to the claim that there was a strong imitation effect after this televised parasuicide.

Adult↗
PubMed1987

Control of exogenous factors affecting plasma homovanillic acid concentration.

Measurements of plasma homovanillic acid (pHVA) concentrations appear to be a valid research strategy in psychiatric disorders in which a central dopamine (DA) abnormality has been implicated. This study provides guidance about the control of some of the exogenous factors affecting pHVA concentrations. Fasting for 14 hours eliminates the dietary effects on pHVA in healthy human subjects. Changing position, walking for 30 minutes, or smoking two cigarettes has no effect on pHVA concentrations.

Adult↗
PubMed1986

Clinical and social characteristics of male parasuicides: variation by employment status and duration of unemployment.

In this study employed and unemployed male parasuicides were compared on a number of clinical, sociodemographic and other characteristics in order to establish which, if any, were significantly related to employment status. A further analysis examined variation in personal attributes by duration of unemployment. The unemployed group was found to contain a higher proportion of individuals who were unmarried, living outside the family, of lower social class, given a diagnosis of abnormal personality, misusing drugs habitually, in trouble with the police and with a criminal record. Comparisons within the unemployed group showed that age and civil state varied significantly by duration of unemployment, but no linear trend was evident. Longer durations of unemployment were associated significantly with personality diagnosis and receipt of psychotropic drug treatment. Within the limits dictated by the study design (cross-sectional, without general population controls), the findings are discussed in terms of their compatibility with the causal or self-selection models of the unemployment-parasuicide relationship.

Adult↗
PubMed1986

Parasuicide and unemployment.

The current economic recession in Europe and North America has led to a renewal of interest in the possible consequences of mass unemployment for the nation's health. This annotation assesses the relationship between unemployment and one indicator of morbidity: parasuicide (non-fatal deliberate self-harm). A previously published review of the literature is supplemented by more recent research, particularly from Edinburgh and Oxford.

Adult↗
PubMed1985

Parasuicide and unemployment among men in Edinburgh 1968-82.

The ecological association between unemployment and parasuicide rates among males in Edinburgh over the period 1968-82 was positive and highly significant (r = 0.77). Similarly, the two rates were found to be correlated across the city wards in 1971 (r = 0.76) and even more strongly in 1981 (r = 0.95). Throughout the period the parasuicide rate among the unemployed was nearly always more than 10 times higher than that among the employed. The long-term unemployed were at much higher risk than those out of work for lesser periods, although the impact of recent job loss was marked. Population attributable risk has shown a tendency to rise in line with the upward trend in the unemployment rate, despite the decline in relative risk over the period. The findings were considered consistent with the view that unemployment increases the parasuicide rate.

Cross-Sectional Studies↗
PubMed1985

Measuring the burden of psychiatric illness on the family: an evaluation of some rating scales.

The gradual shift towards non-institutional treatment for severe and chronic psychiatric illnesses has been accompanied by a recognition of potentially harmful effects ('burden') upon the patient's caregivers. This paper aims to provide a framework for the development of further research into the burden of 'community care' by offering a clear definition of the burden concept, an exposition of the criteria for evaluating rating scales to measure the concept, a review of major rating scales of burden, and some suggestions for improvements in methodology which are urgently required.

Adaptation, Psychological↗
PubMed1984

Trends in parasuicide and unemployment among men in Edinburgh, 1968-82.

Between 1968 and 1982 annual unemployment and annual incidence of parasuicide among men in Edinburgh were positively and highly significantly correlated (r = 0.77). Similarly, they were found to be correlated across the city wards in 1971 (r = 0.76) and, even more strongly, 1981 (r = 0.95). Throughout the period the incidence of parasuicide among the unemployed was nearly always more than 10 times higher than among the employed. Men unemployed for more than a year were at much higher risk than those out of work for shorter periods. These findings were considered to be consistent with the view that unemployment, especially if long term, increases the incidence of parasuicide. The official prediction of an increase in long term unemployment has important implications.

Adolescent↗
PubMed1984

Unemployment and suicidal behaviour: a review of the literature.

In order to provide a framework for reviewing the voluminous literature on unemployment and suicidal behaviour, the author distinguishes between two categories of deliberately self-harmful act: those with fatal outcome (suicide) and those with non-fatal outcome (parasuicide); and differentiates four major types of quantitative research report: individual--cross-sectional; aggregate--cross-sectional; individual--longitudinal; and aggregate--longitudinal. Methodological issues and empirical research findings are discussed separately for each type of study and each category of deliberate self-harm. Cross-sectional individual studies reveal that significantly more parasuicides and suicides are unemployed than would be expected among general population samples. Likewise, parasuicide and suicide rates among the unemployed are always considerably higher than among the employed. Aggregate--cross-sectional studies provide no evidence of a consistent relationship between unemployment and completed suicide, but a significant geographical association between unemployment and parasuicide was found. Results from all but one of the individual longitudinal studies point to significantly more unemployment, job instability and occupational problems among suicides compared to non-suicides. The aggregate longitudinal analyses reveal a significant positive association between unemployment and suicide in the United States of America and some European countries. The negative relationship in Great Britain during the 1960s and early 1970s has been shown to result from a unique decline in suicide rates due to the unavailability of the most common method of suicide. However, despite the firm evidence of an association between unemployment and suicidal behaviour, the nature of this association remains highly problematic. On the basis of the available date, the author suggests that macro-economic conditions, although not directly influencing the suicide rate, may nevertheless constitute an important antecedent variable in the causal chain leading to self-harmful behaviour. Further empirical research based on a longitudinal design is recommended as a matter of urgency so that a more definitive assessment of the aetiological significance of unemployment in parasuicide may be made.

Cross-Sectional Studies↗
PubMed1984

Suicide, unemployment, and domestic gas detoxification in Britain.

Between 1962 and 1971 the United Kingdom suicide rate fell while the unemployment rate rose, contrary both to earlier British experience and recent trends in other developed countries. It is hypothesised that the "British anomaly" is due to the coincident detoxification of domestic gas after 1963. Unemployment and suicide by means other than domestic gas were found to correlate +0.88 between 1955 and 1980, and +0.70 between 1964 and 1974. These findings are discussed with respect to the role of availability of method in the epidemiology of suicide. It is also suggested that the relation between unemployment and suicide is complex and probably largely indirect.

Carbon Monoxide Poisoning↗